ABSTRACT Support is requested for a Keystone Symposia conference entitled Role of the Genital Tract Microbiome in Sexual and Reproductive Health, organized by Drs. Janneke van de Wijgert, Jeanne Marrazzo, Douglas Kwon and Jo-Ann Passmore. The conference will be held in Cape Town, Africa from December 11-15, 2018. Bacteria and fungi residing in the female genital tract have been associated with elevated risks of HIV acquisition and transmission, pelvic inflammatory disease, miscarriage, preterm birth, and invasive maternal and neonatal infections. The increased availability of high throughput genomic testing since the turn of the century has revealed a more detailed picture of these organisms than was possible when evaluation depended on microscopy and culture. The interrelationships between sexually transmitted infections, vaginal dysbiosis, vulvovaginal candidiasis, and vaginal pathobiont carriage are being elucidated, and their effects on the cervicovaginal mucosal barrier and immune system are being characterized. The mechanisms that may lead to adverse outcomes are being unraveled, and an increasing number of interventions are in clinical trials. In this meeting, the current understanding of female and male genital tract microbiology and immunology, including functional microbiology and biofilms, will be presented and knowledge gaps identified. Potential mechanisms leading to adverse outcomes, and a variety of potential prevention and/or treatment interventions, will be presented and discussed. The exponential progress made in recent years will hopefully lead to efficacious public health interventions to reduce the high prevalence of adverse sexual and reproductive health outcomes in women, especially in resource-poor settings.